Testing, Testing
(click)
As of this writing, the press release from CERN is splashed all over the NYT homepage; the news about the rapid HIV test isn’t anywhere above the fold, and it isn’t on the “most viewed” or “most e-mailed” lists.  Don’t get me wrong.  I find the quest for the Higgs boson to be absolutely fascinating - in theory.  In practice, I think that spending 7.5 billion Euros on a Large Hardon Collider when an estimated 50-75 million people on this planet are living with HIV and there’s no cure in sight is an act of criminal negligence.  I’m all for science and abstract knowledge, but I’m equally for keeping in mind the fact that science and research do not happen in a void; they take place within an immanent set of economic and historical conditions.  Research costs money; money is a finite resource; the bigger the slice of pie that goes towards the discovery of subatomic particles, the smaller the slice of the pie that goes towards curing disease.  And while I would love to finally find out for sure whether or not the universe has 11 dimensions that are folded into each other, I would love it even more if entire nations in Africa weren’t on the brink of social and economic collapse because whole generations are being ravaged by disease.  Add to that the fact that we haven’t even begun to experience the full brunt of the HIV epidemic in China, India, and the former Soviet Union, and I think we can agree that there are all kinds of little projects that 7.5 billion Euros could have been used for. 
The irony of this, of course, is the fact that this new particle, if it is in fact the Higgs boson, doesn’t really tell us anything new.  Physicists aren’t looking for it because they think it will help them develop a new theory - they’re looking for it because they think it will confirm a theory they already have.  Basically, all this time and money are being spent so that the 6 or so people in the world who really care about this can look at each other, nod, and say, “Yeah, we were right.”  Nothing fundamentally new will be achieved by this.  As Freud notes in the Introductory Lectures on Psychoanalysis, in his comparison of psychiatry and psychoanalysis, discovering a thing is not the same as discovering an explanation.  
By this point in the history of HIV, large pharma companies have all realized that making people dependent on a lifetime of absurdly expensive drugs is a lot more profitable than finding a cure or a vaccine.  So we shouldn’t expect one of those any time soon.  A rapid home HIV test stands to entirely change the game here, because the primary vector by which HIV is spread isn’t anal sex or intravenous drug use, it’s ignorance.  It’s the ignorance of straight men who think they can fuck other men without a condom because they don’t identify as gay, so they’re not going to catch a gay virus.  It’s the ignorance of white gay men who think it’s OK to have unprotected sex with other white gay men, but not with black or Latino gay men.  It’s the ignorance of people who don’t know how to recognize the flu-like symptoms of seroconversion, who don’t understand the concepts of minimized risk and negotiated safety, who don’t understand that getting tested isn’t just about your own health but about the health of your partners.  Most of all it’s the passion-fueled ignorance of people who, in the heat of the moment, allow themselves to believe that the guy who’s about to put his dick in them is a decent person and would never lie about something as important as his HIV status just to get a piece of ass.  Hah.  But you know what?  Maybe he’s not lying.  Maybe he’s just genuinely ignorant.  Obviously, the paths and processes of transmission differ from context to context, and there’s not necessarily dishonesty involved; a mother who doesn’t have access or the money for the right drugs isn’t transmitting the disease to her newborn out of malice.  But when it comes to the sticky world of urban homosexual intercourse, the ability to just defer sex for 20 minutes while you and your potential partner both test yourselves on the spot right in front of each other introduces a powerful new dynamic into the ethics of transmission, and I have no doubt that such a possibility would greatly decrease both ignorance and dishonesty among gay men. 
It’s not all good news, of course.  If you read the article to the end, you can already see the sickening machinations by which the vile scum who call themselves pharmaceutical companies are plotting to make access to this revolutionary new product unnecessarily difficult and expensive.  Like this delicious bit here:

The home test should be available in 30,000 pharmacies, grocery stores and online retailers by October, said Douglas Michels, OraSure’s chief executive. The price has not yet been set. But he said it would be higher than the $17.50 now charged to medical professionals because the company will do more complicated packaging for the home kit, open a 24-hour question line, and advertise to high-risk groups, including gay men, blacks and Hispanics, and sexually active adults.

Did you pay attention there?  Medical professionals, whose expenses are all covered by the outrageous bills they submit to insurance companies, get it for cheap.  But home users who would have to pay for it themselves get the more expensive version.  Why?  Because the packaging is more complicated.  Uh…maybe you could just make the packaging less fucking complicated?  Oh, and also, the price will go up because customers will have to absorb the cost of advertising for the product.  Admittedly, I’m not an expert on business, but isn’t the expectation sort of that companies pay for advertising because they believe in the product they’re selling and expect to recoup that expense with the profits from their awesome new product?  And finally the best part of all:  the cost will rise because they’re not just advertising their product, they plan to “advertise to high-risk groups, including gay men, blacks and Hispanics, and sexually active adults.”  Because it’s important that high-risk groups know about this exciting new way to spend money - but it’s much less important that this revolutionary product be available as cheaply as possible to these high-risk groups.  Because, you know, it’s a complete accident that minority communities have both the nation’s highest infection rates and the nation’s highest poverty rates.  
Finally, I can’t end this post without taking note of this spectacular quote from one of the nation’s premier HIV experts:  “Dr. Anthony S. Fauci, the longtime AIDS researcher and director of the National Institute of Allergy and Infectious Diseases, called the new test a ‘positive step forward’ and one that could help bring the 30-year-old epidemic under control.”
Really, Anthony?  “A positive step forward”? 

Testing, Testing

(click)

As of this writing, the press release from CERN is splashed all over the NYT homepage; the news about the rapid HIV test isn’t anywhere above the fold, and it isn’t on the “most viewed” or “most e-mailed” lists.  Don’t get me wrong.  I find the quest for the Higgs boson to be absolutely fascinating - in theory.  In practice, I think that spending 7.5 billion Euros on a Large Hardon Collider when an estimated 50-75 million people on this planet are living with HIV and there’s no cure in sight is an act of criminal negligence.  I’m all for science and abstract knowledge, but I’m equally for keeping in mind the fact that science and research do not happen in a void; they take place within an immanent set of economic and historical conditions.  Research costs money; money is a finite resource; the bigger the slice of pie that goes towards the discovery of subatomic particles, the smaller the slice of the pie that goes towards curing disease.  And while I would love to finally find out for sure whether or not the universe has 11 dimensions that are folded into each other, I would love it even more if entire nations in Africa weren’t on the brink of social and economic collapse because whole generations are being ravaged by disease.  Add to that the fact that we haven’t even begun to experience the full brunt of the HIV epidemic in China, India, and the former Soviet Union, and I think we can agree that there are all kinds of little projects that 7.5 billion Euros could have been used for. 

The irony of this, of course, is the fact that this new particle, if it is in fact the Higgs boson, doesn’t really tell us anything new.  Physicists aren’t looking for it because they think it will help them develop a new theory - they’re looking for it because they think it will confirm a theory they already have.  Basically, all this time and money are being spent so that the 6 or so people in the world who really care about this can look at each other, nod, and say, “Yeah, we were right.”  Nothing fundamentally new will be achieved by this.  As Freud notes in the Introductory Lectures on Psychoanalysis, in his comparison of psychiatry and psychoanalysis, discovering a thing is not the same as discovering an explanation.  

By this point in the history of HIV, large pharma companies have all realized that making people dependent on a lifetime of absurdly expensive drugs is a lot more profitable than finding a cure or a vaccine.  So we shouldn’t expect one of those any time soon.  A rapid home HIV test stands to entirely change the game here, because the primary vector by which HIV is spread isn’t anal sex or intravenous drug use, it’s ignorance.  It’s the ignorance of straight men who think they can fuck other men without a condom because they don’t identify as gay, so they’re not going to catch a gay virus.  It’s the ignorance of white gay men who think it’s OK to have unprotected sex with other white gay men, but not with black or Latino gay men.  It’s the ignorance of people who don’t know how to recognize the flu-like symptoms of seroconversion, who don’t understand the concepts of minimized risk and negotiated safety, who don’t understand that getting tested isn’t just about your own health but about the health of your partners.  Most of all it’s the passion-fueled ignorance of people who, in the heat of the moment, allow themselves to believe that the guy who’s about to put his dick in them is a decent person and would never lie about something as important as his HIV status just to get a piece of ass.  Hah.  But you know what?  Maybe he’s not lying.  Maybe he’s just genuinely ignorant.  Obviously, the paths and processes of transmission differ from context to context, and there’s not necessarily dishonesty involved; a mother who doesn’t have access or the money for the right drugs isn’t transmitting the disease to her newborn out of malice.  But when it comes to the sticky world of urban homosexual intercourse, the ability to just defer sex for 20 minutes while you and your potential partner both test yourselves on the spot right in front of each other introduces a powerful new dynamic into the ethics of transmission, and I have no doubt that such a possibility would greatly decrease both ignorance and dishonesty among gay men. 

It’s not all good news, of course.  If you read the article to the end, you can already see the sickening machinations by which the vile scum who call themselves pharmaceutical companies are plotting to make access to this revolutionary new product unnecessarily difficult and expensive.  Like this delicious bit here:

The home test should be available in 30,000 pharmacies, grocery stores and online retailers by October, said Douglas Michels, OraSure’s chief executive. The price has not yet been set. But he said it would be higher than the $17.50 now charged to medical professionals because the company will do more complicated packaging for the home kit, open a 24-hour question line, and advertise to high-risk groups, including gay men, blacks and Hispanics, and sexually active adults.

Did you pay attention there?  Medical professionals, whose expenses are all covered by the outrageous bills they submit to insurance companies, get it for cheap.  But home users who would have to pay for it themselves get the more expensive version.  Why?  Because the packaging is more complicated.  Uh…maybe you could just make the packaging less fucking complicated?  Oh, and also, the price will go up because customers will have to absorb the cost of advertising for the product.  Admittedly, I’m not an expert on business, but isn’t the expectation sort of that companies pay for advertising because they believe in the product they’re selling and expect to recoup that expense with the profits from their awesome new product?  And finally the best part of all:  the cost will rise because they’re not just advertising their product, they plan to “advertise to high-risk groups, including gay men, blacks and Hispanics, and sexually active adults.”  Because it’s important that high-risk groups know about this exciting new way to spend money - but it’s much less important that this revolutionary product be available as cheaply as possible to these high-risk groups.  Because, you know, it’s a complete accident that minority communities have both the nation’s highest infection rates and the nation’s highest poverty rates.  

Finally, I can’t end this post without taking note of this spectacular quote from one of the nation’s premier HIV experts:  “Dr. Anthony S. Fauci, the longtime AIDS researcher and director of the National Institute of Allergy and Infectious Diseases, called the new test a ‘positive step forward’ and one that could help bring the 30-year-old epidemic under control.”

Really, Anthony?  “A positive step forward”? 

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    Rapid HIV testing is not the answer/magical solution to HIV/AIDS in gay/queer/MSM populations. Home kits to ‘accurately’...
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